Provider Demographics
NPI:1992875397
Name:JYRINGI, MARK (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:JYRINGI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5029 ROOSEVELT WAY NE
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3600
Mailing Address - Country:US
Mailing Address - Phone:206-547-4427
Mailing Address - Fax:
Practice Address - Street 1:5029 ROOSEVELT WAY NE
Practice Address - Street 2:SUITE 101A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3600
Practice Address - Country:US
Practice Address - Phone:206-547-4427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU61570OtherUPIN
WAJY5775OtherREGENCE BLUE SHIELD
WA0060139OtherLABOR & INDUSTRIES
WAJY5775OtherREGENCE BLUE SHIELD